After undergoing a three month waiting period my gender practioner proscribed me Estradiol Valerate, to be taken 4mg daily. This is the first time I have taken any medication in line to trasitioning and am very happy to have come this far. I did ask the practioner however, why he was not proscibing anti androgens. He told me that anti-androgens are necessary only where the Estradiol Valerate does not cause sufficient reduction in testosterone production. He requested that I revisit him in three month with up-to-date blood test results to hand. If indeed my testosterone level remained too high he would then proscribe anti androgens as appropriate, but normally this shouldn't happen.

Has anyone else had this experience. Can someone give more?

Most, if not all, of the gender physicians that I have heard of prescribe both an anti-androgen and estrogen for gender transition. It has been my understanding that, given enough estrogen, it will block the effects of testosterone but will be at such a high level of intake to become risky. Hense the addition of an anti-androgen to reduce the amount of estrogen one needs to achive the desired results.

Hi Withheld Desire,

I'm with Christina on this one. I have never heard of a doctor not prescribing some type of anti-androgen when taking estrogen.

Testosterone is a very powerful hormone and will usual block out the effects of the estrogen therapy. I'm not aware of anyone really progressing toward feminization while still having the testosterone in their system.

I'm not a doctor...just sharing some knowledge with you that I've picked up along the way.

Hi Desire,

My dad was a Doctor, and always told me that oral meds tend to be tough on the liver. He never like to give a patient more than what was necessary to do the job. Your Dr, may just want to see how far the T drops before proscribing the amount of anti-androgen. You can get a second opinion from an endocrinologist if your uncomfortable with your doctor's answer, but three months should go by pretty quick.

Jema

And so what would be the advice for a fifty year old person posesssing the tiny testicles of a ten year old whose pituatary system creates pretty much equal the same amount of testosterone as estrogen at low levels. Would the testosterone still overpower the estrogen if given estradiol? I know that at one time after being given steroids from the doctor to cure tendonitis to my wrist my side effects was that I grew hair on my cheeks and got thicker hair on my chin and moustache. (And I was happy to not to have to shave.) :-\

Hi Dev,

I was just sharing something from growing up in a medical family- Dad was an MD, Mom was an RN, and my uncle was an anesthesiologist.

( hey......... they could have done my Orchie! Darn it :-\ )

Any way beyond what I was saying about oral meds being hard on the liver, I couldn't begin to tell how much Estradiol Valerate it would take to over power the testosterone. Every one's body is different and responds to medications accordingly. When it comes to what the best dosage of a hormone is rite for you, it's best to consult an endocrinologist since that is their speciality. That's not to say a regular MD is necessarily unqualified either, but my advice probably would be

Jema

As a TS and, for a number of years, the director of facilitators at one of the oldest TG support groups in the world, I have sat through endless hours of trans folk disputing hormone regimines. In some parts of the trans spectrum, estrogen w/out a blocker is not uncommon. Common opinion is that estrogen will cause femininization even w/out blockers, and that shrinkage and impotence are more caused by spiro and other blockers than the estrogen alone. This is most common in short or long term non op's, people in commited relationship, and those who are escorting (where possession of a working penis and boobs can cost twice as much as a genetic woman)(I knew a couple of girls who were escorting to pay for their operations, but postponed the op because it would too severely shrink their earnings) This option is of course disapproved of by the self described real transsexuals who disavow all those who are not hell bent on SRS.

Another point is that doing things slowly is almost always a good idea, especially where there is a history of depression or mood swings, which describes a disturbinly large percentage of us transpeople. Any time you start mucking about with hormone levels, you are setting yourself up for sometimes wild mood swings, not to mention nausea and some other nasty side effects up to and including death by blood clots, so it is usefull to only introduce one new drug at a time, ramp up slowly, (1mg/day for a week then 2/day for another weekand so on) up to full dose. Stay at full dose for a while and check levels before introducing a new drug. A side note to this is to make a note to yourself. It is highly likely that you are going to undergo mood swings. The next three to six months would not be a good time to make huge life changing decisions. Deciding to transition is by itself a pretty huge life changing deciscion, I have seen transpeople who ended up homeless because within a short time of beginning hormones, they ended jobs, relationships, habits, jumped in their cars and moved among strangers without planning or thought. And being a trans woman broke on the streets is not a good thing.

Remember Rush Slowly

transward

Jema ,

My question was that if one was somewhat of an abnormal male with very little hair --certainly no butt hairs, having small hands, and a very young face for age (get carded still), and with a high soprano singing voice, --(Can you mimic the secret slumber party girls and sing along with the chipmunks?) --and with anecdotal information from a nurse that with me my estrogen and testosterone levels would be fairly equal then would taking estradiol (which I have never done) tip the balance in favor of say growing noticeable breasts --(I already have developed buds but they're assymetrical). I know that in the past steroids had tipped the balance in favor of growing more facial hair so that afterwards I had to shave once or twice a week so that I didn't look too scroungy --(but lately I have found it just nicer to simply stay in bed on a Saturday morning, listening to the radio and leisurely use some tweezers for a few hours while also doing some meditation.) I had also been advized at the time to go ahead and eat a lot licourice for my heart but now later on in life I have read that it could be detrimental in case of high blood pressure but then so could the altitude that I'm living in here in Colorado. So if one were to take say black ohosh or dong quai would that tip the balance too? I'm just wondering because I really don't know but nobody else seems to know either and I'm too poor to go to the doctor just about that. Pretty much most of my life I have lived relatively carefree but nowadays I have to even watch how I get out of bed by deliberately pulling the covers to the side and planting both feet solidly flat on the floor instead of how I was doing, slithering out of the top of the covers and jumping onto one foot next to my bed, since my knee won't take that anymore and I had kept reinjuring it so I know that I am in fact getting older and more decrepit.

:-\

Hi Dev,

I sure can relate to the money issues. Is the a community clinic you can go to? Also I'm not sure what your goals are. Do you want to be more fem or go more towards the buch side?

Huggggsss,

Jema

Thanx guys for your helpful comments. Ideally, I should be more trusting of the docter's proscription and advice. I guess I'm just obsessing as usual.

And hey, what is another three month wait. The first three month wait necessary in order to get where I am now, i.e. on estradial valerate, done me the world of good. There is alot to be learned in rushing slowly, I must admit.